Bed occupancy in acute trusts is already at the most pressured winter levels, trust chief executives and directors have told HSJ.
The high bed occupancy rate in the last month has left acute trust chief executives concerned they will have no capacity to open beds during winter, when admissions tend to rise.
The senior figures warned they have already opened all the extra beds they are able to and are operating at occupancy levels they would not normally expect until later winter months.
One senior leader said their trust is “full to the gunnels”.
They added: “We can’t get patients out that don’t need to be here. At one of our hospitals there are at least 50 patients every day that are medically fit for discharge and can’t be discharged. There’s a massive problem and we’re not making inroads on that.”
One chief executive said their trust is “already fully escalated” and no more beds can be opened.
“The problem for me is I don’t know if we can open any more beds, we’re already fully escalated,” they added.
The chief executive said the trust has been running “winter schemes” non-stop throughout the year “and it’s not making the difference”.
The permanent nature of these schemes means the funding should be permanently funded by commissioners rather than as a winter scheme allocation, they said. The trust has insisted commissioners stop using non-recurrent funding to pay for schemes that run all year.
Another chief executive told HSJ it “already feels like winter” and the trust has had to open extra beds to cope with admission levels that are more in line with December and January in previous years.
James Paget University Hospital Trust recently sent out a “black alert” because all its beds were full.
Two weekends ago, 600 people attended the trust’s A&E department, which was an increase of 8 per cent on the same period last year, director of nursing quality and patient experience Liz Libiszewski said.
The closure of care homes following inspections by the Care Quality Commission has made it more difficult for one trust to move patients out of hospital. Its chief executive said: “Where we’ve got problems is that three care homes have now either closed down or being closed down by the CQC in the past 12 months so we’re losing the capacity to move people out of hospital.”
Bed occupancy is the “main point of concern” for another acute trust chief. They said: “Our occupancy is 99 per cent so we won’t be able to manage the normal seasonal surge which really kicks in in November. The reasons for high occupancy are closure of services at nearby trusts, longer lengths of stay for those awaiting nursing homes and social care combined with increasing complexity in our patients.”